Double localization of Giant Cell Reparative Granuloma of the bone in the same finger Differential diagnosis and treatment

AIM: This article reports a case of GCRG seen in a young man with a rare double localization in the same finger and illustrates the degree of diagnostic difficulty and treatment. MATERIAL OF STUDY: A 16-year-old man presented with dull pain and swelling of the left middle finger. Plain radiography of the hand showed expansive and lucent lytic lesions with circumferential cortical destruction in the small bones of the proximal and middle phalanges. He underwent en-bloc resection and reconstruction. RESULTS: Histologic findings were consistent with the radiologic diagnosis of GCRG, although several of the features were considered atypical, including the appearance of the giant cells and the areas of the stroma that more closely resembled a giant cell tumor (GCT). At 6 months postoperatively, the morphologic recovery was complete and he had returned to unrestricted activities. His range of motion at the involved joint was the almost completely recovered, and his grip strength on the third setting of the Jamar scale was 48 and 42 kg for the right and left hands respectively. CONCLUSIONS: GCRG is a rare intraosseous lesion that must be considered in the differential diagnosis of hand and foot lesions, such us giant cell tumor, brown tumor, giant-cell-rich osteosarcoma.